The randomized clinical trial provides the strongest study design for the evaluation of a diagnostic technology. An emerging diagnostic technology should first be compared as an adjunct to the existing technology to show it adds value before comparing it alone to the existing technology. Fluorescence and reflectance spectroscopy are emerging technologies. In this randomized clinical trial, we propose to compare these emerging technologies adjunctivelyto the existingtechnologies to show they add value. We plan to compare: 645 colposcopy alone to colposcopy + fluorescenceand reflectance spectroscopy,of 600 patients referred with abnormal Papanicoloau smears. An Investigational Device Exemption (IDE) will be obtained for the fluorescence and reflectance spectroscopydevice and the results of optical spectroscopy will be used to decide which additional areas to biopsy and whether or not to treat the patient at that visit. The patients will also receive the informationprovided by optical spectroscopy to see if this information reduces anxiety. The costs saved by using this information will also be acquired in a subsequent chart review and used in the cost-effectiveness analysis. Sensitivities, specificities, ROC curves, AUC, and likelihood ratios will be calculated for the colposcopy arm, and for colposcopy and optical spectroscopy in the combined arm.